Diabetes

Diabetes is a difficult diagnosis for patients of any age. In addition to learning and navigating physical ailments, diabetes patients confront many emotional challenges when dealing with a chronic disease. Patients must first accept their diagnosis and then make significant lifestyle changes to successfully manage the disease. For children, puberty and peer acceptance further complicate matters.

Managing diabetes

Diabetes experts at Park Nicollet help children and families who have been diagnosed with diabetes. "The first thing to keep in mind if your child is diagnosed with diabetes is that it is treatable," says Amy Criego, MD, and pediatric endocrinologist at Park Nicollet Clinic-St. Louis Park. "Diabetes is chronic, but we use a team approach to manage childhood diabetes," she says. "In pediatric endocrinology, we care for children with diabetes from birth through college age until they transition to seeing adult endocrinologists," Dr. Criego says.

Understanding diabetes

Endocrinologists are specialists who deal with hormone abnormalities. Diabetes is caused by the body's inability to produce or properly use the hormone insulin, which controls the body's glucose (sugar) levels. Type 1 diabetes was formerly known as juvenile diabetes, since this autoimmune disorder is typically diagnosed early in patients' lives. "In type 1 diabetes, the body simply doesn't produce insulin," Dr. Criego says. "Type 2 diabetes, formerly known as adult onset diabetes, typically occurs when the body has become resistant to the insulin being made, and does not respond properly to it." Type 2 diabetes has become much more common with children, due in part to the obesity epidemic.

Uncover symptoms

Diabetes may be present, but go undiagnosed for months, or even years, because of its many subtle symptoms. For people with type 1 diabetes, symptoms typically progress rapidly and are more obvious. Dr. Criego encourages you to schedule a pediatrician appointment and evaluation for your child if he or she:

urinates frequently;
is excessively thirsty;
has extreme hunger;
suddenly loses weight;
feels fatigued;
becomes irritable; and
has blurred vision.

"Diabetes is a progressive disease," she says. "If your child has any of these symptoms for longer than a week, have them evaluated." Recent studies from the American Diabetes Association suggest early detection and treatment decrease the chance of complications later in life.

Dealing with reality

"You should learn everything possible about the disease and its treatments," Dr. Criego says. "There is a lot to deal with when a child is newly diagnosed. Our care team works with families on an individual basis to help explain how the disease works, how to monitor blood sugar levels and which medications are needed."

Education is important, and a lot of time is spent teaching children and parents how to properly use medications. "Different types of insulin-delivery devices, such as the insulin pump, are providing options for kids to control their conditions at home and school," Dr. Criego explains. "We work with school nurses and teachers to make sure they are aware of when children need to administer their insulin. For instance, rapid-acting insulin needs to be given more often than older, traditional methods. This means children are typically administering insulin prior to lunch at school."

Many experts, resources

Park Nicollet offers a comprehensive care team, including a pediatric endocrinologist, a pediatric nurse practitioner, certified diabetes nurse educators, nutritionists and psychologists. "We use an electronic medical record to keep open communication between all caregivers," Dr. Criego says. If needed, children also have access to Park Nicollet Methodist Hospital's Eating Disorders Institute through our collaboration to treat the dual diagnosis of type 1 diabetes and eating disorders.

Care team members also work at clinics in St. Cloud, Willmar, Virginia and other communities outside the metro area, as part of the Pediatric Endocrinology Outreach Program. Park Nicollet Health Services and International Diabetes Center at Park Nicollet host monthly support groups and sponsor educational speakers for children and parents. Other programs, such as American Diabetes Association's summer camp for children, also are recommended. Camps offer special opportunities for children with diabetes to connect with their peers.